Nobody should be surprised that Professor Luke Clancy would claim (Irish Times, August 15) that plain packaging of cigarettes “works”, but to support his assertion he cites a number of statistics which should be taking their case to the United Nations Committee on Torture, such has been their mistreatment at the hands of the proponents of plain packaging.

In Professor Clancy’s rush to misquote one part of an official Australian Government report on smoking prevalence, he neglected to even mention another part of it. The less useful aspect, from his perspective, of the Australian household survey shows that the number of daily smokers in Australia between the ages of 12 and 17 – the very cohort that plain packaging is supposed to turn off cigarettes - has increased from 2.5 per cent to 3.7 per cent.

This is despite what Luke Clancy wrote last Friday: “All research to date shows packaging is central in attracting children to tobacco. When stripped of their alluring colours and logos and replaced with textual graphic and health warnings, the packages will transform the relationship between teenagers and tobacco.” The relationship has indeed been transformed. There are now thousands more teenagers having a relationship with tobacco, according to the Australian government.

It should be said that the Australian Institute of Health and Welfare study is carried out every three years with the latest covering 2010-2013. Since plain packs were only introduced in December 2012, campaigners have derived their conclusions about a policy that was only in effect for one third of the survey period. This is more than a little disingenuous, but if Professor Clancy is going to claim that plain packaging is responsible for the “fastest decline in smoking rates in over 20 years” (it’s not, but more on that below) then he equally has to accept that plain packaging is responsible for a rise in teen smoking.

Clancy also neglects to mention that there was a whopping 25 per cent tax hike on tobacco in 2010 which the government itself predicted would reduce the number of smokers "in the order of 2 to 3 per cent” or around 87,000 Australians.

The actual drop in overall smoking prevalence in the three years from 2010 to 2013 was 2.3 percentage points – perfectly consistent with the steady downward trend that has been in existence for many years and which seems to have been totally unaffected by plain packaging. This decline was not even the biggest decline in the last 15 years, let alone the last 20. There was a greater decline in smoking rates between 1998 and 2001 (of 2.4 percentage points).

Clancy disguises this by looking at percentage differences between the percentages rather than looking at the decline amongst the whole population. This is statistical trickery. As smoking rates get lower, it is a mathematical inevitably that an identical decline in the number of smokers will appear to have a larger effect in relative terms. For example, a two percentage point decline in a place where 50 per cent of the population smokes represents a relative decline of four percent, as Clancy defines it, whereas the same decline in a place where ten per cent of the population smokes would represent a 20 per cent decline. But the reduction in the number of smokers is the same in both examples.

Clancy also misrepresents Australian Bureau of Statistics’ data showing a decline in tobacco sales during the first year of plain packaging (December 2012-November 2013). Far from indicating a 3.4 per cent decline (which would not be unusual in any case) the data show that the fall in sales was much smaller (0.9 per cent) in the first year of plain packaging than it was the year before (3.4 per cent). For that matter, it was smaller than the year before that (7.1 per cent) and the year before that (2.5 per cent).

Incidentally, Professor Clancy wrote last week: “It has been reported that the Bill has gone to the EU, as is required practice and that it will be delayed by Europe. It is difficult to see why this is assumed and why is it [sic] reported as seemingly inevitable.” These two sentences illustrate just how out-of-touch Professor Clancy is. The reason that it was reported that the European delay is “inevitable” is that it is a fact. (Newspapers generally strive to report facts - the same cannot always be said of single issue campaigners).

The Bill was notified to Europe in mid-June and, if there were no objections, would have been back with the Irish government by mid-September. There have been a number of very strenuous objections from governments (administrations that haven’t been taken in by Professor Clancy’s distorted data) so the European Commission has doubled the standstill period for the legislation and told the Irish government it cannot proceed next month as it had planned.

It’s that simple Professor. Look it up.

And, for those who need visual stimulation, here's that plain packaging miracle (the "vaccine for lung cancer" - copyright Simon Chapman) in full...

Monday, 29 September 2014

In the previous post in this series, James left a comment asking "is it necessary to state so unequivocally that the problem is less exercise?
I agree it's the most plausible explanation, but there could potentially be others."

My argument is that if, as seems to be the case, calorie consumption has fallen over time, increases in body weight must be due to fewer calories being expended and, therefore, that a reduction in physical activity is the most likely culprit. I appreciate that there are people who believe that a calorie is not a calorie and that changes in the diet could therefore be the issue. I tend to side with the traditional consensus view that a calorie is, in fact, a calorie, but even I wasn't so inclined, it so happens that the consumption the ingredients that some claim are uniquely fattening (notably saturated fat and sucrose) have also declined, so that line of argument seems like a dead end.

There may be other factors that have affected metabolism over time, but physical inactivity remains the main contender for why obesity has risen. All sorts of evidence can be given on this count, only a little of which was documented in The Fat Lie. For example, I read an interesting post by Tim Olds at The Conversation this week:

In 1919, a young woman named E.M. Bedale started postgraduate research at University College London, an uncommon undertaking for a woman at that time. Her studies focused on energy balance in children, which led her to spend several years at a serendipitously eponymous school called Bedales in rural Hampshire.

During her two years at Bedales, Miss Bedale measured the energy expenditure and intake of the school’s students, using methods that are still considered to be gold standards today.

Her data provide a startling contrast to our time. Children from almost 100 years ago were 50% more active than kids today. They accumulated over four hours more of physical activity and sat for three hours less than today’s kids - every day.

Too historical for you? Not 'evidence-based' enough? Then how about this?

Or this...

In the 1960s, half the jobs in private industry in the United States required at least moderate-intensity physical activity, compared to less than 20% today.

Work in factories and farms has given way to office work, and that has amounted to over 400 kilojoules less each day that adults expend at work. This difference alone results in a weight increase of about 13 kilograms over 50 years, which pretty closely matches actual changes in weight.

And in the home...

In many ways, the whole ethos of ease now saturates our society, and efficiency is the hallmark of modernity.

Think about it this way - nobody is in the market for a labour-creating device. Sit-on mowers, leaf blowers, self-opening doors and automatic car windows, robot vacuum cleaners, sensor lighting, dishwashers and microwaves all yield daily microsavings in energy expenditure that add up to hundreds of kilojoules.

In 1900, the average American housewife spent an estimated 40 hours every week in food preparation. Today, that time is barely four hours — and it appears to have reached an absolute minimum.

When it comes to physical activity in one's leisure time, some interesting research was published this year in the American Journal of Medicine. I mentioned it briefly in The Fat Lie but some of the statistics are shocking and require another look. The graphic below shows the proportion of Americans who engage in no leisure activity whatsoever. Click to engorge.

Between 1988-94 and 2009-10, the proportion of men who did no leisure-time physical activity rose from 11.4% to 43.5%. Amongst women the rate rose from 19.1% to 51.7%. These are enormous changes in a relatively short period of time.

There's more to come but this blog post is long enough so I'll come back to it in the near future.

Thursday, 25 September 2014

The soda tax campaign that is underway in Berkeley and San Francisco is asking voters to support paying an unnecessarily high price for a widely consumed product. This is not an easy sell, even for Californians, and so the campaign has tapped into the rampant anti-business mentality of the region by being entirely about 'beating Big Soda'.

The campaigners hope that Californians will be so angered by the thought of an industry making money that they will volunteer to give the government more of their own cash. And for the benefit of the dimmest voters, they've concocted the fairytale that a soda tax isn't a tax that people will have to pay—oh no!—it's merely a 'tax on industry'.

This is a tax on industry, not a sales tax on consumers or a tax on retailers. Distribution companies will pay the tax for the privilege of distributing sodas and other sugary beverages in Berkeley. It will be the companies’ choice whether or not to pass this tax to the people of Berkeley.

Seems legit...

In San Francisco, the pro-tax campaign is being run by a group called Choose Health SF. Their website is a real treat, including such phrases as "Coke and Pepsi are the real nannies" and "Ending hunger is about more than making sure people have enough calories."

Choose Health SF are obsessed with 'Big Soda'. They are particularly annoyed by the "misleading astroturf tactics of the American
Beverage Association". This is a reference to the Coalition for an Affordable City, an organisation set up by the soft drink industry to campaign against "unfair beverage taxes".

Choose Health SF call the Coalition for an Affordable City a "local front group" for Big Soda. By contrast, their
own campaign is about "real grassroots community coalition building". They call on Californians to "Join the soda tax grassroots movement." (To see the kind of people they've been building coalitions with, scroll to the bottom of this post).

So who are these grassroots campaigners who want the government to get more tax revenue? Choose Health SF's domain name was registered by Maggie Muir. Maggie Muir is a partner at Erwin and Muir, a public affairs agency that specialises in political campaigns. Erwin and Muir have been "hired by San Francisco lawmakers to lead the political committee in support of the soda tax".

Choose Health SF is, therefore, a classic astroturf group created and funded by the government to lobby for more government action. It is a state sock puppet.

There will be some people who say that this is fair enough, it's one front group against another. I can't agree with that. If the soda industry wants to use its own money to campaign on an issue that is important to its customers (or any issue, for that matter), then it should do so. Most of its customers will be glad that it is taking a stand, but if there are those who don't support it, they are free to stop buying its products.

But for a government to use taxpayers' money to campaign for higher taxes under another name? No. The taxpayer has no ability to withhold his money from the campaign if they disagree the government's stance on the issue. He is, as Thomas Jefferson put it, forced to "furnish funds for the propagation of ideas he disbelieves and abhors".

Moreover, it is fairly obvious that the Coalition for an Affordable City campaign is funded by the soda industry. On every page of their website it says:

"Paid for by No on E: Stop Unfair Beverage Taxes, Coalition for an Affordable City, with major funding by American Beverage Association California PAC."

By contrast, the Choose Health SF website does not give even a hint that it is funded by the government. There is no 'About Us' page and Choose Health SF describes itself merely as "a political committee organizing to pass a local sugary beverage tax." There is nothing on the site to suggest that it is the work of a public affairs agency working on behalf of the government. Big Soda has to be upfront about its 'front groups', Big Government not so much.

We've seen various state-funded 'public health' agencies attempt the same trick in the UK in recent years (eg. here, here and here). I dunno, perhaps this sort of state-funded activism is par for the course in the USA? Erwin and Muir boast that they have "secured over half a billion dollars in financing for schools, roads, and parks improvements through 2/3rds voter approval", so maybe it is.

Whatever the case, voters in San Francisco need to be aware that the campaign for higher taxes has been orchestrated by the interest group that has the most to gain from them—the government.

Wednesday, 24 September 2014

So Ed Miliband has decided that tobacco companies make too much money and so he's going to help himself to some of it. Looting private industry on a whim is not the best way to convince companies that the UK is the best place to do business, but there you go. The other vultures of the parasitic state immediately began to circle...

This smacks of arbitrary and capricious government. And it will ultimately be paid for by the consumer, as one analyst told the Guardian...

“The obvious solution for companies is likely to be a pass-on of the cost through higher prices, so you would expect the consumer to ultimately bear the cost.”

Yep. But there is one thing that puzzles me about the way the media reported the story and it is this:

The fees, similar to those introduced by Barack Obama in 2009, are to be based on the firm’s market share.

Most newspapers echoed the claim that Obama did the same thing in 2009, but I can't work out what they're referring to. Obama introduced a major tax rise on tobacco in 2009, but that can't be it. Miliband's idea more closely resembles the Master Settlement Agreement, but that was a legal settlement and it happened way back in 1998 under Bill Clinton.

Can any readers explain? Or is this the Labour press office desperately trying to get the words 'Obama' an 'Miliband' into the same sentence?

Monday, 22 September 2014

Sunday, 21 September 2014

Blog post of the week has to be Clive Bates' open letter to 'public health grandees'. It really is a must-read, so if you haven't yet, do read it now. I'd like to highlight a couple of sections: -

Vapers think you don’t understand this model – and you don’t care what the evidence says. You have shown no sign of understanding how this works – and keep seeing it as a tobacco industry plot (they were late to the party) or some sort of rogue medical product. Neither is true. But vapers rightly suspect you are careless with the truth: most public health organisations united to support a ban on snus in the European Union in 1992, again in 2001, and once again in the 2014 Tobacco Products Directive. This is despite indisputable evidence that snus, a very low risk way of taking recreational nicotine, has been highly positive for public health where it is permitted and used in Scandinavia – displacing smoking, diverting smoking onset, and supporting user-driven quitting. There is no scientific, ethical or legal case for banning it – but you supported it anyway. This is the same public health model as vaping, so it is no wonder they don’t trust you. Until you face up to the lethal error you have made on snus, you have not earned the right to a hearing on vaping.

METHODS:This paper exploits a quasi-natural experiment to examine the net effect resulting from these opposing incentives. While two Scandinavian countries, Sweden and Finland, joined the European Union (EU) in 1995, Finland was subject to a pre-existing EU ban on oral tobacco products while Sweden received an exemption. A difference in differences framework is used to estimate the change in the smoking rate in Finland due to the implementation of the ban. A secondary analysis uses Finnish smoking data to test for a structural break in trend.

RESULTS: In the post-ban period, smoking was 3.47 percentage points higher in Finland relative to what it would have been in the absence of the ban.

CONCLUSION: The availability of snus, a less harmful alternative to smoking, appears to have had a positive impact (reduction) on the smoking rate. Offering acceptable alternatives to cigarettes is critical in reducing smoking prevalence.

This study got no media attention and was completely ignored by supposed anti-smoking campaigners. As usual.

Clive also says this about the prohibitionists' insistence that vaping activists are astro-turf groups:

You seem surprised to find there are people who get up and do something, and do it for nothing – you seem to assume someone must be paying if vapers do anything. I can see why you might think this: it rarely happens in your world or it is a distant memory from your more idealistic youth. There are no grass roots or unpaid individuals campaigning for the things you want in this field. You should think of these people more like the activist campaigners you know in drugs or HIV/AIDS. Many vapers are passionate about their experience: they have escaped the death trap of smoking – or are heading that way – and having feelings of pride, empowerment, agency and control, as well as immediate welfare and economic benefits, and a much better long term health prognosis. They want others to benefit from the experience and they really don’t want you to take it all away through clumsy or excessive regulation based on poor science, comprehensive misunderstanding or for ideological reasons. And they don’t want to be collateral damage in your war on Big Tobacco, which is of little relevance to them.

Until quite recently, I assumed that the attempt to polarise every nanny state policy as being 'doctors versus industry' was a marketing ploy on the part of the prohibitionists. It plays well with the media and the dimwitted. I assumed that most of them—with the exception of some of the younger, more naive campaigners and some of the true nutters like Gerard Hastings—understood that millions of people sincerely disagree with them and that it was impossible that all these people could be working for industry.

The e-cigarette issue has made me change my mind. It seems that many - perhaps most - 'public health professionals' genuinely believe that ordinary vapers on Twitter are part of an astro-truf campaign that has been orchestrated by Big Tobacco. It blows the mind that there are educated people who could entertain such a paranoid world of make believe, but if they believe this then there can be no doubt that they also believe that all opposition to policies such as minimum pricing, smoking bans and soda taxes is 'astro-turfed'.

Part of this comes down to an extreme sense of self-righteousness, fostered by living in an echo chamber, that makes it difficult for zealots to see any point of view other than their own. Clive is too polite to mention one of the other reasons why 'public health' people are "surprised to find there are people who get up and do something, and do it for nothing", which is that they would never consider doing anything without being paid for it, preferably by the government. A grass roots, volunteer-run 'public health' group is an oxymoron.

● Average energy intake based on all food and drink purchases has fallen 8.3% between 2001-02 and 2012.

● Energy intake from food and drink recorded as eating out fell 7.3% in 2012 and has fallen by 29% since 2001-02.

● There is a long term downward trend in energy intake since the early sixties (visible in all components of the chart). Combining year on year changes of estimates on like bases suggests that average energy intake per person is 31% lower in 2012 than in 1974.

● Despite decreasing energy intake, over-consumption of energy relative to our needs is a major factor in increasing levels of obesity

Taking the long view, DEFRA provides this graph. It goes back to 1940 and shows three (or, arguably, four) different datasets.

Initially, from 1940, the figures show per capita calorie consumption but exclude calories from alcohol, soft drinks, confectionery and food eaten outside the home. After rising after the war, the trend is downwards after the 1950s.

In 1992, calories from confectionery, soft drinks and alcohol were included, and, in 1994, calories consumed outside the home were also included. The addition of extra items naturally pushed the line higher up the graph, but in each case the trend continued downwards.

In 1948, 2,387 calories per capita were recorded, but this excludes alcohol, confectionery, soft drinks and eating out.

However, by 2012, despite all of the above now being included in the figures, recorded consumption was 2,209 calories per capita, which is to say it was lower than the 1948 figure.

Obesity prevalence is clearly much higher today than it was in 1948 and it seems clear to me—and should be clear to anybody who has the slightest understanding of the difference in the typical lifestyle of 1948 compared with today—that the primary reason for this is a big decline in physical activity, whether it be in the workplace, in the home or in personal transportation. 'Energy in' has gone down, but 'energy out' has gone down even more.

However, as we have seen previously, the nuclear option for who insist that obesity has risen because people are consuming more and more calories is to dismiss the DEFRA data—and all other data that show the same trend—out of hand on the basis that it is self-reported and therefore unreliable.

Aside from the fact that this is simply not true (there is plenty of evidence on household shopping that shows the same decline in calorie consumption), the 'we're eating more' claim is asserted without evidence and can be dismissed without evidence. Merely stating that people under-report what they eat, although true, is not enough to turn the graph upside down under any plausible scenario.

I have picked 1948 as a reference point here because it falls in a period covered by a British Medical Journal study that I briefly mentioned in The Fat Lie. Published in 1953, the study looked at calorie intake and weight changes amongst the British population during the years of rationing. It shows not only how much people were eating, but how much they needed to eat.

Comparison of the relation between the food-consumption levels and the body weight changes recorded in this paper and the calorie value of total supplies of food moving into civilian consumption (Ministry of Food, 1949, 1951a) shows that during 1944, when the calorie value of the total food supply was just over 3,000 per head per day, adult men and women gained weight; that during 1945, when the calorie value was over 2,900, weight was roughly constant; that during 1946 and the early part of 1947, when the calorie level fell below 2,900 and dissatisfaction over the food supply was voiced publicly, adults lost weight. In 1948, when the calorie level had again risen above 2,900, the trend of 1946 and 1947 was reversed.

The authors concluded that the government of the day's advice that an average British adult should consume 2,800 calories a day was 'probably too low'. They suggested that 2,900 calories a day was closer to what was needed to maintain a healthy weight. This was based on empirical data that showed that people tended to lose weight if they consumed less than that.

The very fact that government advice on calorie intake has changed so much over the years is, in itself, a stark recognition that we do not need to eat as many calories as we did decades ago. Why? Because we are considerably less physically active than we were decades ago, not only in the workplace, but also in the home.

Moreover, we do—on average—eat fewer calories than we did decades ago, or even a few years ago. You can argue that we are still eating too much (many people obviously are), but to pretend that we are as physically active as ever whilst eating more than ever is a complete inversion of the truth.

Tuesday, 16 September 2014

The economist Julian Simon once wrote that ‘the economic study of advertising is not deserving of great attention’, ruefully adding that ‘this is not a congenial point at which to arrive after spending several years working on the subject’. Few economists dedicate as much time to advertising as Simon. Most ignore it altogether because its impact on a nation’s economy, though broadly beneficial, is not seen as being terribly important from their perspective. Advertising is certainly important to businesses because it helps decide how much of a given market is taken by each firm, but it does not typically increase the size of the market itself.

This fundamental point is often missed by the critics of advertising who see it as a powerful and malign force that enables businesses to exert control over the hapless public. The most common complaint is that clever marketing manipulates people into buying products that they do not really want while encouraging a culture of rampant consumerism. Some want advertising heavily restricted or even banned.

The general indifference of economists towards advertising means that the popular literature on the subject (if the word 'popular' can be used in relation to this niche field) is often written by those who work in advertising or those who despise advertising. Neither provide a particularly balanced view.

When I first began roaming the staircases of the IEA a few years ago I picked up a copy of a book that was rather different. Advertising in a Free Society, written by Ralph Harris and Arthur Seldon and published by the IEA, was written in 1959 and has been out of print ever since. In it, Harris and Seldon weighed up the economic and social criticisms of advertising, as well as the claims made on its behalf, and concluded that advertising ‘has helped to keep markets competitive, tumbled oligopolists and monopolists, kept prices down, and in the long run made the economic system bow to the consumer’s will’.

This year, it has been my privilege to edit and abridge Advertising in A Free Society for a new edition that has been released today (click here to purchase or for a free download). 55 years after the original book was published, much new evidence has been produced and it largely supports Harris and Seldon's view of advertising as a force for good. Studies show that advertising can help develop brand loyalty in existing customers and it might - at best - entice us into trying a particular brand, but it cannot turn us into regular customers and it cannot coerce us into fundamentally changing our behaviour. The weight of economic evidence shows that advertising follows social trends, it does not initiate them, and companies only start spending the big marketing bucks when they are confident that demand already exists. Advertising is overwhelmingly aimed at getting existing users of a product to either switch brands or stay loyal to their current brand.

Although advertising campaigns are often described as ‘aggressive’, the business of advertising is largely defensive. As much as companies want to attract new customers, their priority is to stop existing customers drifting off to the competition. The ubiquity of expensive marketing campaigns in developed countries is not an expression of corporate power, as critics claim, but of corporate vulnerability. We consumers are fickle, disloyal and light-footed.

It is not that businesses wouldn’t like to manipulate us into buying products we don’t want, only that the lever of manipulation has never been invented. As governments soon discover when they use advertising to encourage us to get out and vote or to eat ‘five a day’, it is very difficult make people do things that they are not already minded to do.

'Ah!', say the critics, 'but if advertising is not very important, why do businesses spend so much money on it?' The truth is that, for all its faults, advertising remains a better way of communicating with the buying public than any of the alternatives. Travelling salesmen and discount vouchers might work for some companies, but to reach a mass audience and develop economies of scale, the mass media is required.

Harris and Seldon noted that many critics of advertising ‘seem to have lost their sense of humour about persuasive appeals that exploit vanity and selfishness and shamefully contain no details of chemical or technical performance. The ordinary shopper has kept his head much better.’ Many of advertising's critics do indeed appear to have a low opinion of the public, whom they assume will buy whatever is put in front of them regardless of quality. In fact, people learn to treat advertising messages with scepticism from a very young age. As Harris and Seldon say in Advertising in a Free Society, ‘The sovereignty of the consumer is much greater than many economists who have never understood the market system have supposed.’

Advertising provides information, albeit from a biased source. It saves us time by reducing search costs, and it is generally associated with lower prices and higher quality. Advertising might be an imperfect means to achieve the goals of both the buyer and the seller, but we would all be worse off without it.

Monday, 15 September 2014

I've started doing a spot of blogging at the Telegraph. Today, it's about a school banning packed lunches...

A new academic year at Milefield Primary School in Grimethorpe, South Yorkshire, gave authorities a fresh opportunity to override the will of parents in the name of heath. As reported in the Telegraph, a ban on packed lunches has so far led to six children being removed from the school by their parents, but the governing body remains unrepentant.

Justifying the new diktat, head teacher Paula Murray applied the newspeak of the public sector, saying that she was "taking a holistic approach to school meals". On the basis that what is not compulsory must be banned, she noted that there is "no requirement for the school to provide an area for children to consume packed lunches" and that the new policy would (in so many words) be based on the pretence that such facilities do not exist. Plenty of seats will be available for those who are prepared to eat school dinners, but they miraculously vanish when a child wants to eat a sandwich.

The reason for the Cancer Council talking about the huge surge in smoking prevalence in this key demographic (smoking rates are highest in the 25-34 year age group) is that it wants to ban smoking outside (no need to make up stuff about secondhand smoke at this stage in the game). In this, it echoes the government of South Australia which started a campaign for the same policy back in May by making this crucial admission:

Health Minister Jack Snelling said the new measures would help to tackle an increase in the State’s smoking rates which have increased from 16.7 per cent to 19.4 percent over the past 12 months.

Combine these two states with New South Wales, where the official survey found a rise in smoking prevalence of 14.7% to 16.4% (not statistically significant, but certainly not indicative of a decline), and plain packaging looks like a damp squib once again.

Black market in tobacco booming in the streets of Sydney, with cheap Asian imports flooding the streets

Cigarette smuggling on the rise, one in eight cigarettes smuggled

Areas with large migrant populations are prime markets for the trade

Some smuggled cigarettes contain ‘mould, faeces and even asbestos’

500,000 cigarettes and $1m in cash seized in recent raids

It is emerging as one of the most lucrative illegal trades on the streets of Sydney’s southwest, but it’s not drug dealing or car boosting — it’s smuggling cigarettes.
Last month, in seven raids across Fairfield and Bankstown, police seized more than 500,000 smuggled cigarettes and $1 million cash.

Wednesday, 10 September 2014

Another 'public health' conference took place this week. This time it was the World Public Health Nutrition Association. Never have those speech marks around 'public health' been more necessary. It was, in truth, a far-left political rally against 'Big Food' and in support of 'Big Government'.

Amongst the speaker was the tree-hugging Trotskyist, Gerard Hastings, and the unctuous brain donor, Aseem Malhotra. The following tweets give you a taste of the conference in all its fanatical glory. Note the intense hatred of business, trade, capitalism and economics. Note also the clear intention to bring about a worldwide treaty in the style of the Framework Convention on Tobacco Control so that your diet can be controlled by international law.

Monday, 8 September 2014

Professor John Ashton, formerly of the Socialist Health Association and currently the head of the UK Faculty of Public Health, had a funny old weekend. He started Friday in true public health form by putting out a statement about e-cigarettes which began with the whopping lie that there is consensus on this divisive issue:

“The average person on the street could be forgiven for being confused about what health professionals think about e-cigarettes. Fortunately, there is common ground among public health professionals.

"FPH doesn’t want to ban so-called ‘nicotine sticks’ [no one calls themselves nicotine sticks - CJS]. We do want to be sure that any benefits they may have don’t undo all the hard work that’s been done over decades to save lives by reducing smoking. We are particularly concerned that ‘vaping’ may lead to young people starting to smoke cigarettes. A recent report from the US backs up this concern [no, it doesn't - CJS].

“We agree with the authors of this paper that we should separate opinion and evidence. At the moment, there is very little hard data about e-cigarettes: until we get some solid facts on their impact on people’s health, we need proper regulations of e-cigarettes, and to encourage anyone who wants to quit smoking to get help from the NHS. That’s proven to be the best way to quit the habit for good.”

It got rather worse for him when he turned in an embarrassing performance on the Jeremy Vine show in which he refused to shut up when asked and rambled on about nicotine causing people to go blind. He told smokers to use the (rubbish and inefficient) NHS Stop Smoking service instead (a service that gives me people free, er, nicotine).

As Clive Bates rightly said on the show, he sounded like a bloke in a bar and that it where he may well have spent the following day because when he got home he went on Twitter to abuse vapers, call women c***s and make various bizarre sexual references. Here are some of his pearls of wisdom:

There was much more of this, all of it now deleted. For me, the most troubling aspect of Ashton's Twitter binge was his urge to seek out tweets that vapers had written weeks or months earlier and insult them as pathetic addicts. This, remember, from a man who heads up a major public health organisation and who regularly appears in the media to "separate opinion from evidence".

As Dick Puddlecote says, the mask has slipped. You have to wonder how many people in the public health racket have the same mentality but manage - as Ashton did until Saturday - to keep it to themselves.

Thursday, 4 September 2014

Dick Puddlecote recently mentioned the latest advocacy-as-science article in BMJ Open. The 'study' is, as he says, nothing more than "a telephone poll of (average) 650 people in just one Australian state
which attempted to disprove claims that plain packaging will encourage
criminal counterfeiters. A very difficult thing to do considering the Sun newspaper collected video evidence in June of an ecstatic Indonesian fake cig manufacturer describing how his business will benefit from plain packaging legislation."

Only the left-wing media bothered to cover this effort, ie. the BBC, the Guardian and the Independent. The latter managed to balls up its report by using the headline 'Australia shows that plain tobacco packaging significantly cuts smoking' (the study had nothing to do with smoking rates), but the Beeb followed basic journalistic standards by quoting opposing views (FOREST and the Tobacco Manufacturers Association) which gave some semblance of balance.

The Guardian report, in the other hand, was extraordinary one-sided from the outset...

Claims that plain cigarette packaging would hurt small independent retailers and increase use of illicit, unbranded tobacco have formed the core of big tobacco’s argument against plain packaging.

But those arguments have been debunked by new Victorian research, which public health experts have described as a win for science.

It included a quote from the lead author (who, tellingly, is a tobacco control 'policy adviser'), as well as a quote from veteran anti-smoking campaigner Mike Daube and, above all, a lengthy quote from Jurassic wowser Simon Chapman:

A professor of public health at the University of Sydney and tobacco control expert, Simon Chapman, said big tobacco feared a domino effect of plain packaging reforms around the world with nine countries implementing or considering it.

“Canada was the first country to introduce graphic warnings on cigarette packets and within 10 years, 60 other countries had followed suit,” Chapman said.

“California did the first banning of smoking in restaurants and now that has swept throughout the world. There are many examples in tobacco control policy of the domino theory at work.”

The tobacco giant Philip Morris has threatened to sue the British government if it forges ahead with its plain packaging reforms.

The arguments from tobacco companies against plain packaging made no sense whatsoever, Chapman said.

“Of course smokers have always known, even before plain packaging, that cigarettes are cheaper in supermarkets,” he said.

“So the only thing that would drive more people away from small retailers would be if supermarket prices fell even further.”

The only 'balance' in the article came in the form of a brief and cursory quote from the Australasian Association of Convenience Stores, half of which was complimentary towards the group that funded the study.

The words used by the reporter - 'debunked', 'big tobacco', 'discredit tobacco reforms', 'made no sense whatsoever' - as well as the tendency to present opinion as fact - '[cigarette packaging] is used as a way of marketing towards young people' -
give the article the feel of an advocacy piece rather than a work of journalism.

So who is this reporter? Step forward Melissa Davey who just happens to be completing a Masters Degree in public health at the University of Sydney where Simon Chapman just happens to be a senior tutor.

Wednesday, 3 September 2014

The Australian Bureau of Statistics has today published tobacco sales figures for the second quarter of 2014 (see table 8 for the data and see here for the background). After the decline in sales that followed the December 2013 tax hike, sales have risen by 1.8 per cent. Perhaps the most plausible reason for the increase is that smokers stockpiled cigarettes prior to the tax rise (which they have now consumed), as well as failed New Year's resolutions to quit smoking.

This is the picture over the last five and half years:

There is not much to say about the recent rise in sales, except that it is the third quarterly increase since plain packaging was introduced in December 2012. Contrast that with the two year period before plain packaging came into force when sales only rose once.

The bigger picture is clear for those who have eyes to see. Firstly, tax rises clearly have some effect on consumption, as might be expected (although these figures do not tell us anything about illicit tobacco sales or smoking prevalence in general). Secondly, plain packaging has been an irrelevance, at best. Tobacco sales were higher by the end of 2013 than they had been at the end of 2012. Only the tax hike of December 2013 saved the anti-smokers' blushes, at least in the eyes of the more gullible sections of the media.

Another 12.5 per cent tax hike has just been introduced. At this rate, they will have to increase the tax rate every quarter.

Tuesday, 2 September 2014

My main reason for going to Australia was to take part in a panel discussion titled 'The Grit in the Oyster' at the Centre for Independent Studies' Consilium conference on the Gold Coast. The purpose of the discussion was the talk 'in praise of contrary opinion'. You can read an edited version of my speech below (published in The Australian), before scrolling down for the punchline.

John Snow is a legend of public health. In the 1850s he investigated a cholera outbreak in London and noticed that the victims' houses were clustered around one particular water pump. He removed the pump's handle and the epidemic came to an end. This led him to conclude that cholera spread through contaminated water and not, as was widely believed, through the air. In one fell swoop, he had invented epidemiology and discovered germ theory.

A lesser known fact about Snow is that he was reviled by much of the medical establishment in his lifetime and germ theory was not accepted as fact until after his death. Wedded to the miasma theory of disease (which, put simply, says that disease is spread by bad smells), doctors were intent on closing down polluting industries in Britain's cities. These industries protested their innocence and found common cause with Snow, who used the issue to promote germ theory.

The editor of The Lancet, a leading medical journal, treated Snow with undisguised contempt. In so many words, he portrayed him as a crank and a hired gun of big business. "The theory of Dr. Snow tallies wonderfully with the views of [industry]", he wrote in a scathing and sarcastic editorial. Snow's theory, he said, was "a mockery of science" and a "wretched crudity". Appealing to the authority of the existing consensus, he said that the belief that cholera was a waterborne disease was not "in accordance with the experience of men who have studied the question without being blinded by theories".

The Lancet was right about Snow being a hired gun. He had received money from the threatened industries to give testimony to a parliamentary committee. But neither his links with business, nor the fact that the establishment disagreed with him, stopped Snow being right and the establishment being wrong. Although doctors eventually came round to Snow's way of thinking and now idolise him, the fact remains that Snow's heresy was not addressed by coolly assessing the evidence, but by appealing to authority, appealing to consensus and dismissing Snow as a tool of big business.

For all his troubles, Snow got an easy ride compared to those who step out of line in the field of public health today. Take Katherine Flegal, a statistician at the US Centers for Disease Control. Last year, she and her colleagues published a systematic review of 97 studies in the Journal of the American Medical Association which found that mild obesity produced no extra mortality risk and that being merely overweight resulted in a small reduction in mortality risk.

Despite being supported with a ream of data, the study was savaged by the public health lobby. Walter Willett, one of the world's most prominent anti-obesity campaigners said: “This study is really a pile of rubbish and no one should waste their time reading it.” A spokesman for the National Obesity Forum said “It’s a horrific message to put out at this particular time" and absurdly suggested that Flegal's "message" was that we can "eat ourselves to death with black forest gateaux.” Willett later organised a symposium in which speaker after speaker lined up to denounce Flegal and her work.

Or take James Enstrom, a vastly experienced and respected epidemiologist who had been working at UCLA since 1976. In 2003, he and a colleague published a study in the British Medical Journal that found no association between secondhand smoke and lung cancer. Many other studies had come to the same conclusion and Enstrom's research had no substantive flaws. Nevertheless, when anti-smoking campaigners heard about the findings, they breached the journal's embargo and hastily organised a press conference in which they slated the study (which they they not yet read) and described the study as "crap" and Enstrom as "a damn fool".

In 2005, Enstrom further blotted his copy book by conducting research on fine particulate matter which cast doubt on the scientific basis of new air pollution laws proposed by the Californian Environmental Protection Agency. Although Enstrom's findings have since been replicated in other studies, he was later sacked by UCLA because his research was "not aligned with the department’s mission”.

Or take the 2011 study by Brand-Miller and Barclay which claimed that sugar consumption had been falling in Australia while obesity had been rising. They and their study - titled 'The Australian Paradox' - have been viciously attacked by anti-sugar campaigners, with the usual accusations of being in the pay of industry. The researchers were eventually charged with scientific misconduct and have only recently been exonerated.

All of these examples involve scientists of good standing whose studies have been published in peer reviewed journals. It is hard to believe that any of them would have been attacked with such vigour had they not been dealing with red button issues that are of great importance to public health pressure groups.

In the 1850s, doctors were committed to make cities smell better. In the 2000s, they were committed to smoking bans. Today, they are committed to fighting obesity, with a particular focus on sugar.

To put it bluntly, the policies had already been decided. The campaigners want to send a clear, unambiguous message to the public while persuading politicians to act. Any research suggesting that a policy is misplaced or directed at the wrong target brings down a firestorm upon the heretical scientist, regardless of the quality of the research or the credentials of the researcher. In each case, the response from the establishment is visceral rather than rational. The implications of dogmatic groupthink and intimidation for the pursuit of sound science - and sound policy - are chilling.

The theme here is, I hope, pretty clear. I am arguing that the establishment often reacts to challenging evidence by resorting to ad hominem attacks (typically based on alleged funding from industry) and appeals to consensus (eg. 'the debate is over') rather than addressing the evidence directly.

Four days after my visit, the Association of Salaried Medical Specialists came back with their rebuttal (to a speech they hadn't heard). The organisation carefully picked apart my arguments, proving beyond doubt that any loss of utility from such taxes would be more than offset by benefits. They demonstrated that indirect taxes on essentials were not, in fact, regressive. They showed that the money raised by sin taxes could not possibly be more effectively spent on anything else. They identified crucial flaws in all studies that have claimed that soda taxes have little or no impact on obesity. And they showed that the Danish fat tax had actually been a success.

“The decision to bring British anti-tax spin doctor Christopher Snowdon [!?! - CJS] to New Zealand last week was just another tired disingenuous attempt to dress up a venal campaign as a genuine debate,” says Ian Powell, Executive Director of the Association of Salaried Medical Specialists (ASMS).

“Snowdon’s attacks on credible medical and social research have been well documented so it was disappointing but hardly a surprise to see him singing to the choir within the NZ Food & Grocery Council about the evils of taxing sugary soft drinks, etc. The Council obviously gives much greater priority to the food industry’s profits than the risk of poor health of New Zealanders.

“What is surprising is that the Food & Grocery Council obviously hasn’t realised the New Zealand public’s distaste for propaganda masquerading as evidence and genuine debate.”

As noted in media coverage http://www.stuff.co.nz/life-style/wellbeing/10443122/Anti-sugar-campaigners-wowsers, the Food & Grocery Council has been at the centre of ‘Dirty Politics’ allegations that it ran sponsored posts on the Whale Oil blog. Both Katherine Rich from the Council and Christopher Snowdon have been referred to in glowing terms on this blog. When Mr Snowden’s [sic] strongest supporters are the Cameron Slater ‘gang’, what more can one say. [I have been mentioned on the Whaleoil blog twice in its entire history - CJS]

“All of this raises questions about the real intent of these people and organisations. Issues like obesity are very important for New Zealand and any discussion of possible solutions, such as taxes on soft drinks, needs to be based on evidence rather than the commercial desires of opaque vested interests.”

Mr Powell says Snowdon’s arguments on diet and obesity have been comprehensively demolished over the years, including in video interviews and articles such as these: http://blogs.channel4.com/tom-clarke-on-science/obesity-crisis-sorting-fat-fiction/1221 and http://www.theguardian.com/society/2014/aug/30/child-poverty-link-malnutrition-rickets. [The first of these links is a video of me talking about obesity, but not sugar/soda/fat taxes. The second just says that the UK Faculty of Public Health supports a sugar tax - CJS.]

He also noted that despite numerous calls to do so, the organisation Christopher Snowdon works for, the UK Institute of Economic Affairs, has consistently failed to reveal its funders. This is despite evidence of its support from the tobacco industry which has been revealed in that industry’s internal documents: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60480-3/fulltext.

“Mr Snowden [sic] is little more than a front for vested business interests seeking to make profits by increasing poor health,” says Mr Powell. “We have enough ‘Dirty Politics’ in New Zealand already without being subjected to the bile of one of their English imports.”

PS. Whilst in Auckland, I was interviewed by the Sun Star Times. The article ('Anti-sugar campaigners "wowsers"') isn't too bad, but it included a mild attack from one of the sugar tax lobbyists. On this occasion, the man throwing brickbats was Tony Blakely. I was booked to debate with Blakely on television, but he bottled it at the last minute.

You can listen to me talking about the Grit in the Oyster on ABC Radio here. Quite a sensible discussion, this one.

A local councillor has spoken out candidly about his addiction to smoking in an attempt to get the country's Smokefree 2025 vision taken more seriously.

The Smokefree 2025 'vision' (AKA the 'endgame') is so obviously a euphemism for prohibition that it's amazing that Kiwi campaigners pretend otherwise. It is therefore refreshing to hear a politician state clearly what the plan is. The reason, however, is mind-boggling.

Whangarei District Council has resolved to have the mayor write to Prime Minister John Key, calling for a ban on the sale of tobacco products on January 1, 2025.

The man behind the movement, councillor Brian McLachlan, has struggled to give up. He says he's had enough, and many other smokers feel the same.

"Giving up is easy. It's the day after, and the day after that, that's the hard part," he says.

"As soon as you start smoking, addiction sets in with a craving that totally subverts your freedom to choose."

Only in the mad, mad world of Public Health is the criminalisation of a product consumed by one in five adults considered to be a pro-freedom move. Orwell would be proud.

"What I need, now, is simply not to have cigarettes
available at the places where I go to fill up my car, buy my groceries
or last-minute stuff at the dairy. Whether I can see the smokes or not, I
know they're there, and I know I can get them."

It's all about ME!!!

"You can ban smoking from yet more places and push me to a place where I stand out in the rain and feel like some sort of second-class citizen. That may have solved your problem, but it hasn't solved mine. I still need a cigarette."

Oh, just have a cigarette then, you weird masochist.

McLachlan says he is not advocating for smoking to become illegal...

Drinking was never illegal in 1920s America but no one was in any doubt that they were living under Prohibition.

...and overseas tourists would still be able to bring in tobacco for personal use.

Monday, 1 September 2014

I'm now back from Australia. The lies, nonsense and gibberish have naturally continued in my absence, such as Robert Lustig doing a convincing impression of a raving fanatic and the latest ravings from Sarah Wollaston, which include this doozy...

[Wollaston] argued that if someone wants to lead an unhealthy lifestyle 'of course that's entirely up to them'.

But the government should intervene, with new regulations if necessary, to make it harder for people to buy junk food.

So not entirely up to them, then. See Tim Worstall for a fuller response to Wollaston's nonsense.

But there was one article of such stupendous idiocy - such hysterical, evidence-free garbage - that I cannot let it lie. Vapers are used to pointless, Polly Filler-esque columnists putting pen to paper before engaging their brains but this, from Rachel Lloyd in the Telegraph, belongs in a class of its own.

'I thought my e-cigarette was a miracle. Turns out, I was smoking the equivalent of 40-a-day'

When my local chemist told me to stop vaping immediately, or risk seriously damaging my health I thought he must be having a mad half hour.

Kindly Mr Patel has always struck me a cautious man. It seemed ridiculous that he was making such a fuss.

'Such a cautious man'. I suppose appearing to have a reckless, devil-may-care attitude is not a good move if you're dispensing potentially dangerous drugs, but anyway...

I just couldn’t grasp that something as innocuous as an e-cigarette, widely regarded as the safe alternative to real cigarettes – and commonly used by smokers to quit - could come with any lasting health risks.

Now, I think differently and others are starting to, as well. This week, the World Health Organisation (WHO) recommended that e-cigarettes should be banned indoors, because they emit chemicals potentially as dangerous as cigarettes and have a potential passive smoking risk.

Doctors are also calling for more research into the long-term effects.

They are indeed, and so they should, but requests for more evidence into a relatively new product are not evidence of harm to the user, let alone to non-users.

I took up vaping two years ago, during a particularly stressful period and soon found myself addicted - puffing away throughout the day.

Nicotine is addictive. Surely you knew that already?

It was the summer of 2012 when I first succumbed to the habit. My lovely stepfather died towards the end of July that year after a brief battle with cancer. His decline was swift it took us all by surprise and it was hard to see him in hospital without dashing outside for secret weeping breaks.

Meanwhile, my mother - always the rock of the family - was battling a rare and punishing neurological disorder known as Chronic Cluster Headache. Seemingly, overnight she went from perfect health to a hellish existence.

To add to the drama, I started hearing a permanent, high-pitched ring in my ears which I suspected might be psychosomatic but was nonetheless terrifying. I was subsequently diagnosed with tinnitus caused by partial hearing loss in my right ear.

Panic stricken, I wondered if I would ever get to sleep without swallowing copious amounts of sleeping pills.

So, the very last thing on my mind when my friend Jason offered me a drag on his e-cigarette one evening at the pub was whether it might be bad for my health.

Why is that, Rachel? Considering the circumstances, I would have thought that health issues would be at the forefront of your mind.

In fact, all things considered, I could easily have forgiven myself for smoking 20 Malboro Lights a day and weeping into my pillow each night in an orgy of self pity.

Yes, OK, we get it. It was the worst of times. However, you didn't start smoking 20 Marlboro Lights a day. You started vaping instead, which is much the safer option.

That said, I was never a committed smoker. Even back in my twenties my flirtation with nicotine was half-hearted. I was one of those annoying ‘social smokers’ who could be found in pubs ‘borrowing’ fags off bystanders to go with chilled, deliciously deep glasses of Chardonnay.

You do, indeed, sound like an annoying person.

Yet as I sucked on Jason’s e-cigarette (containing, he explained, a harmless amount of nicotine and "few other chemicals") I was struck by how lovely it felt to breathe so deeply.

Jason's description of e-cigarettes, though vague, is basically correct. The enjoyment you got from the e-cigarette probably had less to do with the joy of breathing deeply than the joy of nicotine entering your blood supply.

When very stressed I tend to revert to tight, shallow breathing. Vaping encouraged me to expand my lungs properly - even if I was filling them up with mysterious substances.

The motion of vaping is soothing and instantly calming, without the guilt that accompanies conventional smoking.

I loved the way the tip of my e-cigarette lit up with each drag, mimicking the glow of a cigarette. When I exhaled a sheet of mist shot out of my mouth like a plume of diamond-coloured smoke.

The reason most people use them (which you have managed to ignore) is that they are cheaper and healthier than smoking. Not everybody wants to smoke and most people who vape aren't particularly interested in being 'hip' or 'environmentally-friendly'.

I loved being able to indulge myself in the office, at the cinema, over dinner and on the tube. And when I saw the rather decadent TV adverts for e-cigarettes, earlier this year, I smiled away sucking at the tip of my e-stick. I was already one of the initiated - and it felt good to be 'ahead of the curve'.

I think I hate you.

But as the months went by I began to question the extent of my vaping. I was spending at up to £30 a week on e-cigarettes

I spend less than £10. Presumably you were using a cigalike.

If I left home without it, I would fly into a panic and immediately prioritise finding a chemist.

Yes, you're definitely using a cigalike. By the way, they are available from many shops other than chemists. Or perhaps you haven't found a newsagent who strikes you as sufficiently 'cautious'.

I couldn’t function properly without my new prop and my dependence increased. It had seemed like a relatively harmless habit. Could vaping really be any more threatening to one’s health - and bank balance - than caffeine, or alcohol?

The available evidence suggests that vaping is about as harmful as caffeine (ie. not very much at all) and rather less harmful than alcohol.

Eventually, in June this year, I sought the advice of my chemist as to ‘cutting down’. Mostly, I wanted to save money.

The existing evidence does not suggest that nicotine causes heart disease. Insofar as they might cause circulation problems, it would be as a result of a mild increase in the heart rate, as you would get from caffeine or the nicotine products that kindly, cheerful, cautious old Mr Patel happens to sell in his chemist.

"Some have also been found to emit formaldehyde, which is a carcinogenic.”

Formaldehyde can be found in apples, pears, bananas, beetroots, apricots, tomatoes, plums, beef, lamb, cabbage and many other natural foods. The dose makes the poison. It is far from clear whether the small amounts of formaldehyde in tobacco cigarettes cause cancer, let alone that much smaller amounts found in some e-cigarettes do so.

I was horrified, but worse was to come.

Horrified? You said earlier that you thought he was 'having a mad half hour', but never mind.

Two days later I scurried to my doctor for a second opinion. She asked exactly how much vapour I was consuming per hour.

“Up to forty inhalations an hour on a particularly stressful day,” I admitted.

According to her, I was inhaling the equivalent of 40 fags a day – at least in terms of nicotine. There was no doubt about it, I was a vape addict.

If your doctor thinks that a single breath of e-cigarette vapour equates to a whole cigarette then you should seek a third opinion. Or do some research.[UPDATE: As Geoffers points out in the comments, the doctor is referring to 'up to forty' inhalations per hour. My mistake. Even on a 'particularly stressful day', this is still not the equivalent of 40 cigarettes a day. 30 puffs of 18 mg/ml fluid is the nicotine equivalent of one cigarette. If awake for 15 hours, inhaling 40 inhalations an hour, the equivalent daily cigarette consumption would be one pack.]

My love affair with vaping began to unravel. I just couldn’t continue with the habit knowing the potential dangers.

What a dilemma! How to avoid the dangers of nicotine?

But giving up wasn't easy. It took several attempts to finally quit.
In the end I switched to a nicotine patch and slowly weaned myself off
for good.

That's right, by taking nicotine in a different form. Lovely, safe nicotine from the pharmaceutical industry instead of horrible, killer e-cigarette nicotine.

If I’d known two years ago what I know now, I would never have started vaping.

With the greatest respect, you don't seem to know anything now. Your knowledge of e-cigarettes has actually gone backwards and you haven't made any effort to look at the significant body of research that exists. Assuming that Mr Patel and your doctor actually exist, you have been unfortunate in asking the opinion of two people who have also neglected to read the research. Nevertheless you could have done so yourself before writing pig ignorant rubbish in a national newspaper.

And I would strongly discourage anyone else from taking it up. Yet, even as I write, I can feel a insidious craving to vape – oh the bliss contained in that first puff of e-cigarette.

Talking about the 'bliss' of vaping might not be the best way to 'strongly discourage anyone else from taking it up', but that's your problem, I suppose.

But I will stand firm come what may...

Such valour! It's only a matter of time before this lady is awarded an award for courage. Her bravery in the face of almost insurmountable first world problems horror brings a tear to the eye.

...and would strongly encourage others to make themselves aware of the risks, too.

I would strongly encourage you, Rachel Lloyd, to make yourself aware of the risks. If you can't be bothered with PubMed, you can start with this list. Please don't write anything else about e-cigarettes until you can tell your arse from your elbow.

About Me

Writer and researcher at the Institute of Economic Affairs. Blogging in a personal capacity.
Author of Selfishness, Greed and Capitalism (2015), The Art of Suppression (2011), The Spirit Level Delusion (2010) and Velvet Glove, Iron Fist (2009).

"Of all tyrannies, a tyranny exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent moral busybodies. The robber baron's cruelty may sometimes sleep, his cupidity may at some point be satiated; but those who torment us for our own good will torment us without end, for they do so with the approval of their own conscience."